Concerns over undocumented foreigners in hospitals “cannot be ignored” – Parliament

Parliament’s Portfolio Committee on Health has acknowledged growing concerns raised by organisations and opposition parties regarding the provision of healthcare to undocumented foreign nationals in South African hospitals. 

Anti-migrant group Operation Dudula is the latest to raise this issue, forcefully blocking access to hospitals to anyone without a South African ID.

Earlier this month, ActionSA called for patients at public hospitals to be categorised, with ActionSA Member of Parliament and medical Doctor Kgosi Letlape calling this a “blind spot” in the healthcare system.

“Millions of foreign nationals, many of whom are undocumented or lack any form of medical insurance, reasonably make use of taxpayer-funded public healthcare services,” he said.

“In a public health system already buckling under pressure, with overcrowded hospitals, long queues, understaffing and medicine shortages, this lack of oversight is reckless and unsustainable.”

The issue has been raised within the ANC government itself, with Limpopo Premier Phophi Ramathuba hauled before the Health Professionals Council of South Africa in November 2024.

This was for comments she made about Zimbabwe not assisting with money to care for its nationals in strained Limpopo Hospitals.

The Portfolio Committee on Health responded to this growing pressure, and said that allowing undocumented foreigners access to emergency medical services is mandatory under international law. 

The National Health Insurance and section 27 of the South African Constitution also include provisions that explicitly state that undocumented individuals will be provided with emergency medical services. 

“However, challenges have arisen regarding undocumented citizens,” said Parliament’s Health Committee chairperson, Sibongiseni Dhlomo. 

“These concerns cannot be ignored. We must engage with stakeholders. South Africans, without identity documents, could be prejudiced,” Dhlomo said.

As such, he said that Minister of Health Dr Aaron Motsoaledi will meet with the leadership of these organisations.

The committee added that the solution to rectifying this issue is to revise and amend the Immigration Act and citizenship laws.

“The Refugees Act also needs repeal. Some of these acts have a wide scope. The country does not have unlimited resources,” Dhlomo said. 

According to the chairperson, amending these acts will clarify who can and cannot receive healthcare services from the government.

“Worldwide, when you go to other countries, you have the cover of medical insurance, and you pay for the services. It is something that should and will be attended to.”

The parliamentary committee called on support from the Department of Home Affairs to expedite the amendments to the acts that affect this process. 

“Unsustainable,” says critics

Operation Dudula has viewed Dhlomo’s statements as a win, posting on its official social media page: “The chairperson has stated that non-South Africans are entitled only to emergency medical services at public health facilities, rather than the full range of comprehensive healthcare available to South African citizens.”

The anti-migrant group is a splinter faction of the Put South Africans First movement, formed in 2021. 

The group said it has raised concerns over a lack of clear guidelines on what constitutes an emergency, which creates ambiguity on access to care. 

Members of the group have been blocking foreign nationals from receiving healthcare in public clinics and hospitals for weeks.

Operation Dudula claims these undocumented migrants are adding pressure to the already-overburdened health system.

The Non-Governmental organisation Doctors Without Borders has recently condemned the acts of this group and those associated with it and called for immediate action from the Health Ministry.

“For several weeks now, anti-migrant groups have camped outside dozens of clinics and hospitals in Gauteng, preventing non-South Africans from entering public health facilities to seek medical care, irrespective of their legal documentation status,” the NGO said. 

It was reported at several clinics and hospitals across Gauteng that members of these groups are stationed at gates and entrances, demanding to see proof of South African ID. 

In some cases, security staff and healthcare workers were found to be working with these groups. 

The organisation added that the blame for the overburdened healthcare system should fall on the appropriate health departments, and not on non-South Africans. 

Operation Dudula said it has noted that NGOs and members of parliament appear to be opposing its activities, leaving the group “ feeling challenged and misunderstood”.

ActionSA has submitted proposals to amend section 27 of the Constitution, on the grounds that the country doesn’t have unlimited public healthcare resources.

“This situation is not mirrored in any other country, where foreign nationals are typically required to possess medical insurance as a condition of their visa applications,” said Letlape.

“Yet South Africans are being gaslit into accepting this unsustainable burden as normal.”

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